Treatment of intracranial aneurysms with large-diameter (≥5.5 mm) Derivo Embolization Devices, with particular focus on 7 and 8 mm diameter devices.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Interventional Neuroradiology Pub Date : 2024-05-05 DOI:10.1177/15910199241248479

Lukas Goertz, David Zopfs, Jonathan Kottlors, Lenhard Pennig, Stefan Schob, Marc Schlamann, Christoph Kabbasch

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引用次数: 0

Abstract

Objective: There are few studies on flow diverters with diameters >5 mm. We present our preliminary experience with the 5.5-8 mm Derivo Embolization Device (DED) implants for the treatment of cerebral aneurysms.

Methods: A consecutive series of 26 patients (median age: 60 years) treated for 32 aneurysms in 26 procedures was retrospectively analyzed for procedural characteristics, complications, and mid-term angiographic results.

Results: The median aneurysm size was 10.5 mm, 2 of 30 (6%) aneurysms were ruptured and 9 (28%) had a fusiform or dissecting morphology. DED implantation was performed in the internal carotid artery in 18 of 26 (69%) procedures and in the vertebrobasilar artery in 8 (31%). Device deployment failed in 1 (4%) procedure. The 7 and 8 mm implants were successfully deployed in 5 cases. Additional balloon angioplasty or stent implantation was performed in 3 (12%) cases to improve wall apposition. Complications included 1 (4%) major stroke and 2 (8%) minor strokes. Angiographic follow up at a mean of 6 months showed complete occlusion in 8 of30 (27%) aneurysms and favorable occlusion in 14 (47%).

Conclusions: The use of large diameter DEDs was safe and feasible. The mid-term occlusion rates are acceptable considering the complex subset of aneurysms studied. Further studies are warranted to define the indications for large-diameter DEDs and to evaluate their long-term efficacy.

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使用大直径（≥5.5 毫米）Derivo 栓塞设备治疗颅内动脉瘤，特别关注直径为 7 毫米和 8 毫米的设备。

目的：有关直径大于 5 毫米的血流分流器的研究很少。我们介绍了使用 5.5-8 毫米 Derivo 栓塞装置（DED）植入体治疗脑动脉瘤的初步经验：我们回顾性地分析了连续26例患者（中位年龄：60岁）的手术特点、并发症和中期血管造影结果：动脉瘤的中位尺寸为 10.5 毫米，30 个动脉瘤中有 2 个（6%）破裂，9 个（28%）呈纺锤形或剥离形态。26 例手术中有 18 例（69%）在颈内动脉植入了 DED，8 例（31%）在椎基底动脉植入了 DED。1例（4%）手术中设备部署失败。有 5 例手术成功植入了 7 毫米和 8 毫米植入物。有 3 例（12%）患者进行了额外的球囊血管成形术或支架植入术，以改善血管壁的贴壁情况。并发症包括1例（4%）严重中风和2例（8%）轻微中风。平均 6 个月的血管造影随访显示，30 个动脉瘤中有 8 个（27%）完全闭塞，14 个（47%）闭塞良好：结论：使用大直径 DED 安全可行。结论：使用大直径 DED 是安全可行的，考虑到所研究动脉瘤的复杂性，中期闭塞率是可以接受的。有必要开展进一步研究，以确定大直径 DED 的适应症并评估其长期疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...